20 Healthy Heart Tips

We fear cancer and are appalled by growing rates of diabetes. But heart disease is still the No. 1 killer of both women and men. You already know the usual advice for heart health: eat right, don't smoke, exercise regularly, lessen stress. What does that mean in practical terms?

Top 20 Healthy Heart Tips:

1. Stay away from trans-fats

We know that trans fats-found in French fries and many commercially processed foods-raise LDL (bad) cholesterol levels, decrease HDL (good) cholesterol, and reduce blood vessel function by 30 percent compared to saturated fat. They're so dangerous, the FDA now requires food labels to list trans fat content. Here's the catch: under the regulations, if a serving contains less than 0.5 grams, manufacturers can claim their product is free of trans fats. So a product containing 0.4 grams can be labeled as trans-fat free-but eat three servings of three of these foods, and you've consumed a whopping 1.2 grams of trans fats. The best protection: stay away from any food that lists "partially hydrogenated" or "shortening" on its ingredient list. Or, better yet, skip packaged foods altogether in favor of a whole-foods diet.

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2. Increase fiber

Foods high in soluble fiber, such as oatmeal, apples, prunes, pears, and beans, can hamper the absorption of cholesterol into your bloodstream, and eating 5-10 grams or more of soluble fiber per day has been shown to lower both total and LDL cholesterol. If you don't get enough, certain fiber supplements can help. For instance, blond psyllium, at a dosage of 10-12 grams per day, has been shown to lower LDL levels. Try to get at least 25 grams of fiber in your diet daily.

3. Get enough Vitamin D

Getting enough vitamin D can reduce your risk of heart disease by as much as 47 percent. The best source is direct exposure to sunlight (without sunscreen) for 20-30 minutes per day. If you have dark skin, skin cancer fears, or live in an area that doesn't get a lot of sun, vitamin D supplements can help. Dosage recommendations range from 400 IU to 2,000 IU per day for cardio-protective benefits.

4. Supplement with sterols

These naturally occurring substances block the body's absorption of cholesterol, and some studies suggest that sterols can lower LDL by as much as 15 percent without affecting HDL levels. You'll find them in small amounts in a wide variety of foods, or you can choose a plant sterol supplement. Studies show effects at doses of 2 grams per day.

14 Supplements that contain sterols:

Cranberries

CoQ10

Garlic

Green tea

Omega-3s

Chromium

Turmeric

Magnesium

Psyllium

Sterols

Vitamin D

Arginine

Melatonin

Valerian, hops, lemon balm

5. Consume cranberries

They keep blood cells from clumping, increase HDL levels, and have potent anti-inflammatory effects. The antioxidants in cranberries also keep LDL cholesterol from oxidizing; oxidized cholesterol is more likely to stick to artery walls and cause atherosclerosis, or hardening of the arteries. Skip the sugary cranberry juice "cocktail," and add 100 percent cranberry juice to water or your usual juice. Or use cranberry extract supplements for the same benefits. And wash them down with plenty of water: five or more glasses a day is associated with reduced risk of heart disease.

6. Decrease stress

Long-term, chronic stress is hard on the heart, but occasional adrenaline boosting can naturally upset heart rhythm and boost heart health. Alternate excitement and stress reduction; playing hooky from work every once in a while can lower heart attack risk. And practice calming your mind. In one study, people with heart disease who practiced meditation daily halved their risk for heart attack, stroke, and death.

7. Avoid sugar

Studies in the 1960s first linked higher sugar intake with increased cardiovascular disease, and later studies found that eating sugar lowers HDL levels and boosts LDL and triglycerides. Even teens are at risk; those who eat too much sugar substantially increase their risk of heart disease later in life. And any food with a high glycemic index-especially sugar, pasta, rice, potatoes, and bread-can impact the heart. In one study, women with the highest intake of these foods were more than twice as likely to develop heart disease as women with the lowest intake. Steer clear of high glycemic foods in general, and swap sugar for honey in small amounts; studies have shown that honey contains antioxidants that can protect the heart from damage.

8. Eat adequate protein

Research shows that eating adequate protein lowers heart disease risk by as much as 26 percent, probably because it replaces high-glycemic carbohydrates in the diet. Good sources: beef, chicken, and eggs are high in B vitamins to reduce levels of homocysteine, a dangerous compound that can cause narrowing of the arteries. Eggs also contain betaine, which can lower homocysteine by as much as 75 percent. Always choose lean, grass-fed and organic protein sources; they're lower in fat and calories, and contain conjugated linoleic acid (CLA), a fatty acid that can reduce cancer risk.

9. Do not grill food

Grilling and other high-heat cooking methods form compounds in meat that cause inflammation and oxidative damage, and increase heart disease risk. For safer grilling, use lean meat and marinate it in lemon juice and olive oil. Or wrap foods in foil pouches and place them on the grill to avoid direct contact with heat and lessen the formation of dangerous compounds. Even better, dust off your crock pot, and cook meat the old-fashioned way: slow and low.

10. Drink filtered coffee.

Unfiltered varieties (such as espresso and French-pressed) contain diterpenes and other compounds that can increase the risk of heart disease. And drink it in moderation: coffee can increase blood pressure and arterial stiffness, and drinking more than six cups per day increases cholesterol and boosts blood levels of heart-damaging homocysteine by as much as 10 percent. Green tea makes a great alternative. Its antioxidant flavonoids-the protective compounds also found in cranberries-relax blood vessels and thin blood.

11. Increase omega 3 essential fatty acids

They're high in omega-3 essential fatty acids that help prevent clotting, reduce inflammation, and lower blood pressure. Wild (not farmed) salmon and tuna are also good sources of omega-3s, but because they're small, sardines tend to have fewer toxins than these larger fish. If you're not a fish fan, use supplements. The American Heart Association recommends taking about 1 gram (1,000 mg) of omega-3s per day.

12. Exercise

Exercise strengthens the heart, but beware of jogging down city sidewalks: exposure to air pollution increases risk of heart disease. Even short-term exposure to smoggy air can upset electrical activity of the heart, trigger stroke and heart failure, and exacerbate arterial disease. And choose exercise that you love. People who stick with a certain activity, even if it's walking or gardening, are likely to live the longest.

13. Eat foods rich in chromium

Green beans are a good source of chromium, a heart-protective nutrient that improves insulin sensitivity and helps the body metabolize cholesterol. Other food sources of chromium include broccoli, potatoes, orange juice, and turkey. Studies have shown that 200 mcg per day can reduce the risk of heart disease and diabetes; that's hard to get from foods, so take a chromium picolinate supplement for insurance. While you're at it, toss in a handful of chopped broccoli-eating more vegetables can reduce your risk of heart disease by up to 22 percent.

14. Eat more legumes

It's loaded with fiber-rich beans to lower cholesterol. In some studies, people who ate four or more servings of beans each week reduced their risk of heart disease by 22 percent. Plus, chili is packed with lycopene-rich tomatoes, which can help inhibit LDL oxidation.

15. Eat peanuts

Almonds and walnuts are often touted for their heart-health benefits, but peanuts may be even better. They're rich in monounsaturated fats, which regulate cholesterol levels and blood pressure. In one study, people who ate peanuts lowered their LDL and total cholesterol levels and increased their HDL without making any other dietary changes. Macadamia nuts also have heart-protective effects.

16. Wash hands often

Wash your hands often. People with the highest levels of antibodies-substances produced when the body is fighting off infections-also had more clogging of their arteries. The same goes for brushing your teeth; studies have shown a correlation between gum disease, cavities, and increased risk of heart disease.

17. Consume ginger, garlic, and turmeric

Indian food is rich in heart-healthy ginger, garlic, and turmeric, the spice that gives curry its color. Turmeric contains curcuminoids that can reduce inflammation and prevent atherosclerosis, and may lower total cholesterol. Not an Indian-food fan? Take turmeric capsules; dosages range from 600-1,200 mg per day standardized to 90 percent or more curcuminoids.

18. Get enough sleep

Inadequate shut-eye-five hours or less each night-can increase risk of heart disease by 40 percent. It may be that sleep disturbances elevate blood pressure and reduce insulin sensitivity, which can impact heart health. Studies have also shown that people who complain of fatigue have higher levels of fibrinogen, a protein that can cause blood to clump and reduce blood flow to the heart. Trouble sleeping? Try melatonin, valerian, or other natural sleep aids. (For more on sleep, see "Successful Slumber" p. 38.)

19. Eat magnesium-rich foods

Spinach is high in magnesium, which reduces platelet clumping, lowers blood pressure, and regulates heart rhythms. Pumpkin seeds, Swiss chard, beans, and fish are other good sources. Or take magnesium supplements to ensure you're getting enough. Dosage recommendations range from 400-1,000 mg per day.

20. Take L-arginine.

This amino acid is a precursor to nitric oxide, a compound that keeps arteries flexible, increases blood flow, and improves blood vessel function. Some studies have suggested that L-arginine reduces the risk of atherosclerosis and can lower blood pressure. Recommended dosages range from 750 mg to 3 grams per day, taken between meals.

Healthy Heart Tips from the Experts

1. What food should be eaten by everyone to support heart health?

Fish-primarily fatty fish, says Keri Marshall, ND. "This in part because of the omega-3 essential fatty acids, but also because fish is a lean source of protein," says Marshall. A 3-oz. serving of wild salmon, for example, delivers about 1,000 mg of omega-3s and 19 grams of protein. Keri Marshall, MS, ND, specializes in pediatrics, women's medicine, chronic disease management, and integrative health.

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2. Lower homocysteine naturally.

"Studies have shown that garlic supplementation can lower homocysteine levels by up to 35 percent," says Matthew Budoff, MD. "High homocysteine levels, even if you don't have high cholesterol, can be a risk factor for the development of a heart attack." Matthew Budoff, MD, is a cardiologist in Southern California who has done extensive clinical research on Aged Garlic Extract.

Lisa Turner is a chef, food writer, product developer, and nutrition coach in Boulder, Colo. She has more than 20 years of experience in researching and writing about clean, nourishing foods, and coaching people toward healthier eating habits.

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